THOMAS W EDHOLM Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****27

License Status

NOT RENEWED

Business

First Name

THOMAS W

Last Name

EDHOLM

Business Name

THOMAS W EDHOLM

Original Issue Date

02/20/1996

Effective Date

02/20/1996

Expiration Date

07/31/1999

City

WAUKEGAN

State

Zip

60085

County

LAKE

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

09/26/2006